This 32-year-old female with Marfan's syndrome was being followed echocardiographically for some years to monitor aortic root dimensions after ectasia was discovered on investigation of a murmur. The latest echo showed marked proximal aortic dilation >5.5 cm and moderate aortic insufficiency. The dilated sinuses of Valsalva and ascending aorta are shown. (Pulmonary trunk has been airbrushed away to reveal aortic root anatomy.)

Composite Graft Repair of Aortic Root Aneurysm

The patient underwent combined ascending aorta and valve replacement. The coronary ostial patches were isolated and spared. The dilated, paper-thin ascending aorta and incompetent aortic valve leaflets were excised, and replaced with a composite graft, to which the coronaries and distal arch were reattached. (Pulmonary trunk has been airbrushed away to reveal aortic root anatomy.)